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iii iiiiiiiiiiii iii <br />US Postal Service <br />~ Recejpt,for Certified Mail <br />W No Insurance Coverage Provided. <br />Q Do not use for Intema6onal Mail Ses revers <br />~ <br />.: Mtq, ~S fN nl <br />> '' ~ <br />c <br />0 Pos7 • Slere. D~ a r- <br />j~ <br />r_n Rlslegg § <br />N <br />Certified Fee <br />E <br /> <br />~ spedalbelivary Fee <br />~ R%slricidd Delivery Fee <br /> Rehm <br />i <br />t <br />~ p <br />eos <br />wtxxn d Date <br />,~~ ReWmR <br />'Q <br />-Q DaIe,B Adlt <br />TOTAt <br />P <br /> o ~ ees <br />i <br /> Pasenark or D <br /> 1 <br />__~ <br />T Cn <br />_. ~ <br />~ Z L92 124 602 ,~~c n <br />o ' -'CG . <br />A <br />O <br />;; SENUE(4: <br />a .Complete items rantl/or 21or additional services. <br />w • Complete items 3. Qa, and db. <br />d • Print your name and atltlress on the reverse of this form so Thal we can return This <br />'^ cartl to you. <br />~ • Allach Ihis form to the front of the mailpiece. or on the back ll space does not <br />` perms <br />. Write 'Reurn Receipt Regcesled'on Ih¢ maup~ece below the article number. <br />t • The Return Receipt will show to whom the article was delrveretl antl the dale <br />delivered. <br />0 3. Article Addressed to: 4a. Article <br />d~~~ ~uas ~~tiir~~ c~ _ !~ <br />a <br />I also wish to receive the <br />following services (tor an <br />extra feed: <br /> <br />1. ^ Addressee's Address d <br />2. ^ Restricted Delivery N ' <br /> <br />Consult bostmaster for fee. a <br />o f~"1-/~~ V W u~ ` ~ ' ~ f c' ^ Registered <br />" ~O ~D.~' ~~-.±. ~ `~ ^ Express Mail <br />/~1 ~ t ~ ^ Return Receipt for <br />I`~~o2,~a' /, , / ~ GI~ yr ~ 7. Date of Delivery <br />and lee is paid) <br />0 <br />X ~ua~S~ <br />T <br />t" 164S~7p.$~38'I',11,„9ecero~Art99a <br />^ Ceditied ~ <br />nsured O1 <br />c <br />~, N <br />' tJ o <br />rn ~ <br />T <br />leQU re y <br />~eJ / A <br />,-O°~ ~ . <br />wzsssve-e~oazs QplitBSNC HBFUfD M2Celpt ' <br />